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Subcutaneous sarcoidosis: report of two cases and review of the literature

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Abstract

Sarcoidosis is a multisystemic disease with cutaneous lesions present in about one fourth of patients. Cutaneous lesions may be specific or nonspecific based on the presence or the absence of sarcoidal granulomas. Subcutaneos sarcoidosis is the less frequent of the specific cutaneous lesions of sarcoidosis. We report here 2 new cases and review 83 cases reported in literature of subcutaneous sarcoidosis. Subcutaneous sarcoidosis present usually with asymptomatic firm nodules covered by normal-appearing skin, mostly on the forearms and legs. Diagnosis may require a high index of suspicion. In the vast majority of patients, subcutaneous nodules were the manifestation that allowed the diagnosis of systemic sarcoidosis. There is a strong association between subcutaneous sarcoidosis and bilateral hilar lymphadenopathy (72.7%). About 15% of patients have in order of frequency uveitis, parotitis, arthritis, mucositis, dactylitis, neurological and renal involvement, hepatosplenomegaly.

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References

  1. Iannuzzi MC, Rybicki BA, Teirstein AS (2007) Sarcoidosis. N Engl J Med 357:2153–2155

    Article  PubMed  CAS  Google Scholar 

  2. Fernandez-Faith E, McDonnell J (2007) Cutaneous sarcoidosis: differential diagnosis. Clin Dermatol 25:276–277

    Article  PubMed  Google Scholar 

  3. Darier J, Roussy G (1904) Un cas de tumeurs benignes multiples (sarcoides souscutanées ou tuberculides nodulaires hypodermiques). Ann Dermatol Syphiligr 5:144–149

    Google Scholar 

  4. Ahmed I, Harshad SR (2006) Subcutaneous sarcoidosis: it is a specific subset of cutaneous sarcoidosis frequently associated with systemic disease? J Am Acad Dermatol 54:55–60

    Article  PubMed  Google Scholar 

  5. Marcoval J, Moreno A, Mana J, Peyri J (2008) Subcutaneous sarcoidosis. Dermatol Clin 26:553–556

    Article  PubMed  Google Scholar 

  6. Marcoval J, Mana J, Moreno A, Peyri J (2005) Subcutaneous sarcoidosis: clinicopathological study of 10 cases. Br J Dermatol 153:790–794

    Article  PubMed  CAS  Google Scholar 

  7. Heller M, Soldano AC (2008) Sarcoidosis with subcutaneous lesions. Dermatology OH 14:1

    Google Scholar 

  8. Vainsencher D, Winkelmann RK (1984) Subcutaneous sarcoidosis. Arch Dermatol 120:1028–1031

    Article  PubMed  CAS  Google Scholar 

  9. Chen HH, Chen YM, Lan HH, Lee CH, Chen DY (2009) Sonographic appearance of subcutaneous sarcoidosis. J Ultrasound Med 28:813–816

    Article  PubMed  Google Scholar 

  10. Kerner M, Ziv M, Abu-Raya F, Horowitz E, Rozenman D (2008) Subcutaneous sarcoidosis with neurological involvement: an unusual combination. IMAJ 10:428–430

    PubMed  Google Scholar 

  11. Hirano A, Kataoka M, Nakata Y, Takeda K, Kamao T, Hiramatsu J, Kimura G, Tanimoto Y, Kanehiro A, Tanimoto M (2005) Sarcoidosis occurring after interferon-α therapy for chronic hepatitis C: report of two cases. Respirology 10:529–534

    Article  PubMed  Google Scholar 

  12. Hoffmann RM, Jung MC, Motz R, Gössl C, Emslander HP, Zachoval R, Pape GR (1998) Sarcoidosis associated with interferon-a therapy for chronic hepatitis C. J Hepatol 28:1058–1063

    Article  PubMed  CAS  Google Scholar 

  13. Cacoub P, Sbai A, Frances C, Genesti C, Hausfater P, Piette JC (2000) Systemic sarcoidosis during interferon-alpha therapy for chronic hepatitis C virus infection. Gastroentérol Clin Biol 24:364–366

    PubMed  CAS  Google Scholar 

  14. Cogrel O, Doutre MS, Marliere V, Beylot-Barry M, Couzigou P, Beylot C (2002) Cutaneous sarcoidosis during interferon alfa and ribavirin treatment of hepatitis C virus infection: two cases. Br J Dermatol 146:320–324

    Article  PubMed  CAS  Google Scholar 

  15. Rogers CJ, Romagosa R, Vincek V (2004) Cutaneous sarcoidosis associated with pegylated interferon alfa and ribavirin therapy in a patient with chronic hepatitis C. J Am Acad Dermatol 50:649–650

    Article  PubMed  Google Scholar 

  16. Gitlin N (2002) Manifestation of sarcoidosis during interferon and ribavirin therapy for chronic hepatitis C: a report of two cases. Eur J Gastroenterol Hepatol 14:883–885

    Article  PubMed  Google Scholar 

  17. Voelter-Mahlknecht S, Benez A, Metzger S, Fierlbeck G (1999) Treatment of subcutaneous sarcoidosis with allopurinol. Arch Dermatol 135:1560–1561

    Article  PubMed  CAS  Google Scholar 

  18. Bachelez H, Senet P, Cadranel J, Kaoukhov A, Dubertret L (2001) The use of tetracyclines for the treatment of sarcoidosis. Arch Dermatol 137:69

    PubMed  CAS  Google Scholar 

  19. Schaumann J (1916–1917) Etude sur le lupus pernio et ses rapports avec les sarcoϊdes et la tuberculose (observation 50). Ann Dermatol Syph 6:368–373

    Google Scholar 

  20. Laplane ML (1921) Un cas de sarcoϊde hypodermique de la jambe. Bull Soc Fr Dermatol Syph 28:75–79

    Google Scholar 

  21. Gorl P (1924) Ein Beitrag zur Kasuiistik des subcutanen Sarkoids Darier-Roussy. Arch Dermatol Syph 148:130–141

    Article  Google Scholar 

  22. Gougerot H, Burnier R, Eliascheff O (1932) Tuberculose pernio du nez et tuberculoses “sarcoıdes” hypodermiques disséminées. Bull Soc Fr Dermatol Syph 39:218–220

    Google Scholar 

  23. Maloney ER, Combes FC (1936) Darier-Roussy’s sarcoid, with special reference to its tuberculous etiology. Arch Dermatol Syph 33:709–724

    Google Scholar 

  24. Marten RH, Warner J (1967) Sub-cutaneous nodular sarcoid. Trans St Johns Hosp Soc 53:160–161

    CAS  Google Scholar 

  25. Schirmer D (1975) Subcutaneous nodular sarcoidosis (sarcoid Darier-Roussy). Z Hautkr 50:837–838

    PubMed  CAS  Google Scholar 

  26. Clayton R, Wood P (1974) Subcutaneous nodular sarcoid. Dermatologica 149:51–54

    Article  PubMed  CAS  Google Scholar 

  27. Gross MD, Andriacchi F, Gordon R, Maddox D (1977) Nodular subcutaneous sarcoidosis. Arch Dermatol 113:1442–1443

    Article  PubMed  CAS  Google Scholar 

  28. Scadding JG (1967) Sarcoidosis. Eyre and Spottiswoode, London

    Google Scholar 

  29. Boyd RE, Andrews BS (1981) Sarcoidosis presenting as cutaneous ulceration, subcutaneous nodules and chronic arthritis. J Rheumatol 8:311–316

    PubMed  CAS  Google Scholar 

  30. Marzano AV, Gasparini G, Caputo R, Alessi E (1998) Subcutaneous sarcoidosis following hypophysectomy for pituitary microadenoma inducing Cushing’s disease. Int J Dermatol 37:798

    Article  PubMed  CAS  Google Scholar 

  31. Girao L, Bajanca R, Feio AB, Apetato M (2000) Systemic sarcoidosis revealed by the coexistence of scar and subcutaneous sarcoidosis. J Eur Acad Dermatol Venereol 14:428–430

    Article  PubMed  CAS  Google Scholar 

  32. Kuramoto Y, Shindo Y, Tagami H (1988) Subcutaneous sarcoidosis with extensive caseation necrosis. J Cutan Pathol 15:188–190

    Article  PubMed  CAS  Google Scholar 

  33. Weltfriend S, Harth Y, Katz I (1989) Subcutaneous sarcoidosis in a patient with malignant carcinoid tumor of the colon. J Am Acad Dermatol 20:507–508

    Article  PubMed  CAS  Google Scholar 

  34. Kroll JJ, Shapiro L, Koplon BS, Feldman F (1972) Subcutaneous sarcoidosis with calcification. Arch Dermatol 106:894–895

    Article  PubMed  CAS  Google Scholar 

  35. Gallimore AP, George CD, Lampert IA (1990) Subcutaneous sarcoidosis mimicking carcinoma of the breast. Postgrad Med J 66:677–678

    Article  PubMed  CAS  Google Scholar 

  36. Higgins EM, Salisbury JR, Du Vivier AW (1993) Subcutaneous sarcoidosis. Clin Exp Dermatol 18:65–66

    Article  PubMed  CAS  Google Scholar 

  37. Curco N, Pagerols X, Vives P (1995) Subcutaneous sarcoidosis with dactylitis. Clin Exp Dermatol 20:434–435

    Article  PubMed  CAS  Google Scholar 

  38. Ohi T, Saijo S, Tagami H (1996) Coexistence of subcutaneous sarcoidosis of the sole and scar sarcoidosis. Acta Derm Venereol 76:500

    PubMed  CAS  Google Scholar 

  39. Losada A, Garcia-Doval I, de la Torre C, Cruces MJ (1998) Subcutaneous sarcoidosis worsened by cyclosporin treatment for pyoderma gangrenosum. Br J Dermatol 138:1103–1104

    Article  PubMed  CAS  Google Scholar 

  40. Barnadas MA, Rodríguez-Arias JM, Alomar A (2000) Subcutaneous sarcoidosis associated with vitiligo, pernicious anemia and autoimmune thyroiditis. Clin Exp Dermatol 25:55

    Article  PubMed  CAS  Google Scholar 

  41. Mingins C, Williams MR, Cox NH (2002) Subcutaneous sarcoidosis mimicking breast carcinoma. Br J Dermatol 146:924–925

    Article  PubMed  CAS  Google Scholar 

  42. Ruiz de Erenchun F, Vazquez-Doval FJ, Idoate M, Leache A, Quintanilla E (1992) Subcutaneous nodules as the first clinical manifestation of sarcoidosis. Clin Exp Dermatol 17:192–194

    Article  PubMed  CAS  Google Scholar 

  43. Shidrawi RG, Paradinas F, Murray-Lyon IM (1994) Sarcoidosis presenting as multiple subcutaneous nodules. Clin Exp Dermatol 19:356–358

    Article  PubMed  CAS  Google Scholar 

  44. Shigemitsu H, Yarbrough CA, Prakash S, Sharma OP (2008) A 65-year-old woman with subcutaneous nodule and hilar adenopathy. Chest 134:1080–1083

    Article  PubMed  Google Scholar 

  45. Chiang JK, Ortiz-Ferrer LC, Remlinger K, Bronson DM (2002) Subcutaneous nodules in a patient with hydrocephalus. Arch Dermatol 138:259–264

    Article  PubMed  Google Scholar 

  46. Fichtel JC, Wiggins Duckworth AK, Soares T, Lesher JL (2006) Subcutaneous sarcoidosis presenting after treatment of Cushing’s disease. J Am Acad Dermatol 54:360–361

    Article  PubMed  Google Scholar 

  47. Kalb RE (1988) Sarcoidosis with subcutaneous nodules. Am J Med 85:731–736

    Article  PubMed  CAS  Google Scholar 

  48. Bosnic D, Baresic M, Bagatin D, Ilic I (2010) Subcutaneous sarcoidosis of the face. Intern Med 49:589–592

    Article  PubMed  Google Scholar 

  49. Celik G, Ciledag A, Akin P, Simsek Y, Kaya A, Numanoglu N et al (2010) Subcutaneous sarcoidosis with plantar involvement. Ann Dermatol 22:435–438

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy

    Camilla Dalle Vedove & Giampiero Girolomoni

  2. Section of Pathology, Department of Pathology and Diagnostic, University of Verona, Piazzale LA Scuro, 10 37134, Verona, Italy

    Chiara Colato

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  1. Camilla Dalle Vedove
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  2. Chiara Colato
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  3. Giampiero Girolomoni
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Correspondence to Camilla Dalle Vedove.

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Dalle Vedove, C., Colato, C. & Girolomoni, G. Subcutaneous sarcoidosis: report of two cases and review of the literature. Clin Rheumatol 30, 1123–1128 (2011). https://doi.org/10.1007/s10067-011-1731-4

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  • DOI: https://doi.org/10.1007/s10067-011-1731-4

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